Andrew Jason Dichsen, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056003353 Issued in IL

Practice address

1022 E Wesley Dr
O Fallon, IL 62269-6136

Phone

(618) 744-6613

NPI assigned

Nov 2, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powerback Rehabilitation LLCGroup PAC ID 2365359932, 600 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • O Fallon, IL
  • NPI 1982018362

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Occupational Therapist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1134836786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 DUSTIN LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696102",
            "telephone_number": "618-830-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 E WESLEY DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696136",
            "telephone_number": "618-744-6613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Fountain Lakes Dr",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622692595",
            "country_code": "US",
            "telephone_number": "217-267-6042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICHSEN",
        "first_name": "ANDREW",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "IL",
            "license": "056003353",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056003353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dentists of Ofallon PLLC
• Richard Derby, MD
• Jennifer Leigh Deschene, LMT
• Rajeev Dewan, M.D.
• Jennifer Donnell Dial
• Kristi Kay Dieckmann, D.C., M.S.
• Jamie Diekemper, RBT
• Kelly Ann Diekemper
• Amanda Marie Dillard, LCPC, NCC
• Angela Marie Dillick

• Occupational Therapist in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.